Heavy menstrual bleeding (HMB) associated with anticoagulant therapy is often an underrecognized but common issue. Premenopausal women who are on anticoagulant therapy should be made aware of the potential effect of the therapy on menstrual bleeding. This article gives an overview of assessment and management of anticoagulant-associated HMB. There are many causes of abnormal uterine bleeding (which includes HMB): polyps, adenomyosis, leiomyoma, and malignancy or hyperplasia.
Other causes include coagulopathy, ovulatory dysfunction, endometrial dysfunction, and iatrogenic etiologies. Anticoagulant therapy-associated HMB comes under “coagulopathy” category, which also includes other hemostatic disorders, such as von Willebrand disease, platelet function disorders, coagulation factor deficiencies, or defects of fibrinogen. There have been reports about anticoagulants being associated with…
